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Commercial Insight: Rheumatoid arthritis - Anti-TNFs defend first-line biologic position despite competition

Publication Date December 2008
Publisher Datamonitor
Product Type Report
Pages 272
ISBN Number not applicable
Product Code DAT14045
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Summary

Introduction

Datamonitor forecasts that total sales for the seven major rheumatoid arthritis markets will grow from $7 billion in 2007 to over $12 billion in 2017. The sustained uptake of anti-TNFs combined with the launch of several new biologic products will drive growth in the short-and mid-term. However, biosimilar entry will cause a small contraction in market value at the end of the forecast period.

Scope

  • In-depth analysis of the current and future rheumatoid arthritis market across the US, 5EU and Japanese markets, and a 'rest of world' snapshot.
  • Rheumatoid arthritis sales forecasts for over 20 key brands to 2017, and total brand figure to benchmark indication-specific sales
  • Provides detailed brand analysis, including discussion of all anti-TNFs and impact of alternative biologic products like Actemra
  • Assess the strategies of several key developers in the rheumatoid arthritis market

Highlights

Simponi (golimumab) exemplifies a brand adopting both follow-on and dual formulation strategies, but positioning with Remicade will be challenging. Careful brand management, sales and marketing efforts and a well executed switching strategy will see Simponi achieve blockbuster status in the seven major markets.

The TNF-failure pool will increase considerably as patients cycle through a maximum of 2-3 TNF therapies. Currently, Orencia and Rituxan/MabThera compete in this sub-population, which will become increasingly crowded. With its well-perceived safety profile and Actemra's US approval delay, Orencia will cement its first-line position in TNF-failures.

Although some novel biologic products, have amassed convincing efficacy data against anti-TNFs, their use will be limited to the anti-TNF failure patient population, at least in the mid-term. To progress up the treatment algorithm, new agents need to demonstrate superiority to anti-TNFs and show cost-effectiveness.

Reasons to Purchase

  • Quantify the current size of rheumatoid arthritis sales in the seven major markets and understand trends in the Rest of World
  • Assess the commercial opportunities for non-anti-TNF biologic products including Orencia, Rituxan/MabThera, Actemra, ocrelizumab and ofatumumab
  • Detailed case studies analysing Simponi's product positioning and epidemiology-based assessment of biologic therapies by line and type of therapy

Content

  • ABOUT DATAMONITOR HEALTHCARE
  • About the Immunology & Inflammation pharmaceutical analysis team
  • CHAPTER 1 EXECUTIVE SUMMARY
    • Strategic scoping and focus
    • Datamonitor insight into the disease market
    • Related reports
  • CHAPTER 2 MARKET DEFINITION
    • Market definition for this report
    • Biologic DMARDs
    • TNF inhibitors
    • Interleukins
    • Selective T cell co-stimulation modulator
    • B cell targets
    • Traditional DMARDs (non-biologic DMARDs)
    • ICD-10 codes used to define the rheumatoid arthritis market
    • Assumptions and caveats for diagnosis value estimates
    • Diagnosis value based on retail data only
  • CHAPTER 3 MARKET OVERVIEW
    • Seven major markets
    • Current and future market assessment
    • TNF inhibitors drove growth in the seven major rheumatoid arthritis markets between 2004 and 2007
    • Launch of two new biologic classes contributed to growth in the rheumatoid arthritis market between 2004 and 2007
    • US is the largest rheumatoid arthritis market, but 5EU and Japan experienced higher sales growth between 2004 and 2007
    • Rheumatoid arthritis market volume is increasing, but due to the uptake of biologics, sales growth is outstripping it
    • The seven rheumatoid arthritis markets will grow from $7,245m in 2007 to $12,568m in 2017
    • Opportunities and threats
    • Opportunities
    • Threats
    • US
    • Current and future market assessment
    • US experienced the lowest sales growth between 2004 and 2007
    • US will continue to be the largest of the seven rheumatoid arthritis markets
    • Opportunities and threats
    • Opportunities
    • Threats
    • Japan
    • Current and future market assessment
    • Japan was the fastest growing market from 2004 to 2007
    • 2017 rheumatoid arthritis sales in Japan will be almost double sales in 2007
    • Opportunities and threats
    • Opportunities
    • Threats
    • Five major European markets (5EU)
    • Current and future market assessment
    • Opportunities and threats
    • Opportunities
    • Threats
    • France
    • Current and future market assessment
    • Germany
    • Current and future market assessment
    • Italy
    • Current and future market assessment
    • Spain
    • Current and future market assessment
    • UK
    • Current and future market assessment
    • Rest of World snapshot
    • Current market assessment
    • Rest of World forms only 15% of global rheumatoid arthritis market sales
    • Humira's sales drove growth in US, 5EU and the rest of world from 2004 to 2007
    • Asia-Pacific experienced the fastest growth in the Rest of World between 2004 and 2007
    • Canada is the largest of the Rest of World markets
  • CHAPTER 4 BRAND DYNAMICS
    • Overview of competitive landscape
    • Patient acquisition process
    • Introduction
    • Patient care path
    • Points of influence in the patient care path
    • Trigger Point 1: Disease duration and activity influence use of biologics
    • Trigger Point 2: Movement from anti-TNFs to biologics with alternative mechanisms of action
    • Drivers of brand choice
    • Disease modification and side-effects are the most important factors to prescribing physicians
    • Factors driving brand choice in the anti-TNF class
    • Patient preference can influence anti-TNF choice
    • Patients wish to participate in treatment decisions regarding anti-TNFs
    • Factors driving brand choice in the cytokine drug class
    • Similar choice between anti-TNFs and cytokines
    • US formulary status for leading brands
    • Enbrel has the most favorable formulary status of the biologic DMARDs
    • Trends in marketing strategies
    • Datamonitor's dosing assumptions for brand forecasts
    • TNF inhibitors
    • Efficacy of TNF inhibitors
    • Safety of TNF inhibitors
    • TNF inhibitors - sales forecast to 2017
    • Enbrel (etanercept; Amgen, Wyeth, Takeda)
    • Product profile
    • Product positioning
    • Marketing mix
    • SWOT analysis
    • Brand forecast to 2017
    • Remicade (infliximab; Centocor/Johnson & Johnson, Schering-Plough and Mitsubishi Tanabe)
    • Product profile
    • Product positioning
    • Marketing mix
    • SWOT analysis
    • Brand forecast to 2017
    • Humira (adalimumab; Abbott, Eisai)
    • Product profile
    • Product positioning
    • Marketing mix
    • Brand forecast to 2017
    • Simponi (golimumab; Centocor/Johnson & Johnson, Schering-Plough, Mitsubishi Tanabe, Janssen Pharmaceutical)
    • Target product profile
    • Development overview
    • Product positioning
    • SWOT analysis
    • Drug forecast to 2017
    • Cimzia (certolizumab; UCB, Otsuka)
    • Target product profile
    • Development overview
    • Product positioning
    • Marketing mix
    • SWOT analysis
    • Drug forecast to 2017
    • Other cytokine targets (non-TNF biologics)
    • Other cytokine targets - sales forecast to 2017
    • Actemra (tocilizumab; Chugai, Roche)
    • Product profile
    • Development overview
    • Product positioning
    • SWOT analysis
    • Brand forecast to 2017
    • Orencia (abatacept; Bristol-Myers Squibb)
    • Product profile
    • Product positioning
    • Marketing mix
    • SWOT analysis
    • Brand forecast to 2017
    • Rituxan/MabThera (rituximab; Genentech, Biogen Idec, Roche and Chugai)
    • Product profile
    • Product positioning
    • SWOT analysis
    • Brand forecast to 2017
    • Ocrelizumab (Genentech, Biogen Idec, Roche and Chugai)
    • Target product profile
    • Development overview
    • Product positioning
    • SWOT analysis
    • Brand forecast to 2017
    • Ofatumumab (Genmab, GlaxoSmithKline)
    • Target product profile
    • Product positioning
    • SWOT analysis
    • Brand forecast to 2017
    • Other promising late-stage pipeline agents
    • JAK inhibitors
  • CHAPTER 5 KEY DEVELOPERS
    • Strategic overview
    • Trends in corporate strategy
    • Several companies will enter the market with follow-on products
    • Companies are going for dual subcutaneous and intravenous delivery formulations
    • Amgen
    • Corporate strategy
    • Rheumatoid arthritis portfolio assessment
    • Roche
    • Corporate strategy
    • Rheumatoid arthritis portfolio assessment
    • Bristol-Myers Squibb
    • Corporate strategy
    • Rheumatoid arthritis portfolio assessment
  • CHAPTER 6 CASE STUDIES
    • Case study 1 - Patient-based rheumatoid arthritis market forecasts
    • Comparison between patient-based forecast and IMS forecast
    • Methodology
    • Sensitivity analysis
    • Case study 2 - Portfolio management: Simponi's (golimumab) positioning strategy
    • Scenario A - Immediate switch to subcutaneous formulation
    • Scenario B - Delayed switch to intravenous formulation
    • Conclusion - Scenario B benefits Simponi and anti-TNF franchise
    • Simponi (golimumab, CNTO-148) pricing scenarios
  • BIBLIOGRAPHY
    • Journal papers
    • Websites
    • Datamonitor reports
    • Publications
  • APPENDIX A - MARKET ASSUMPTIONS
    • New product launches
    • Patent expiries
    • US
    • Arava (leflunomide) used as a case study for brand erosion after small molecule patent expiry in the US
    • Data definitions, limitations and assumptions
    • Standard units
    • Japanese market data
    • Rest of World
    • Derivation of sales forecasts and pricing trends
    • Forecast methodology
  • APPENDIX B
    • Contributing experts
    • Report methodology
    • About Datamonitor
    • About Datamonitor Healthcare
    • About the Immunology & Inflammation analysis team
    • Disclaimer
    • Table 1: Datamonitor's definition of rheumatoid arthritis
    • Table 2: Rheumatologist breakdown by region for IMS Prescribing Insight data, 2007
    • Table 3: Rheumatoid-arthritis specific sales ($m) split by drug class in the seven major markets, 2004-07
    • Table 4: Rheumatoid arthritis-specific volume sales (million standard units) split by drug class in the seven major markets, 2004-07
    • Table 5: Sales forecasts in rheumatoid arthritis in the seven major markets ($m), 2007-2017
    • Table 6: Patent expiry dates and level of biosimilar risk for the biologic brands for rheumatoid arthritis
    • Table 7: Cost ($) per year per patient for common biologic agents prescribed for rheumatoid arthritis in the US, 2007
    • Table 8: Summary of opportunities and threats in the seven major rheumatoid arthritis markets, 2008
    • Table 9: Sales and growth of rheumatoid arthritis drug classes in the US, 2007
    • Table 10: Sales forecasts in rheumatoid arthritis in US ($m), 2007-2017
    • Table 11: Summary of opportunities and threats in the rheumatoid arthritis market in the US, 2007
    • Table 12: Japan sales and growth of anti-TNF and traditional DMARD drug classes, 2007
    • Table 13: Sales forecasts in rheumatoid arthritis in Japan ($m), 2007-2017
    • Table 14: Summary of opportunities and threats in the rheumatoid arthritis market in Japan, 2007
    • Table 15: Sales of the Top-10 rheumatoid arthritis drugs in the five major EU markets ($m), 2007
    • Table 16: Sales forecasts for rheumatoid arthritis in the five major European markets ($m), 2007-2017
    • Table 17: Summary of opportunities and threats for rheumatoid arthritis in the five major European markets, 2008
    • Table 18: Sales forecasts in rheumatoid arthritis in France ($m), 2007-2017
    • Table 19: Sales forecasts in rheumatoid arthritis in Germany ($m), 2007-2017
    • Table 20: Sales forecasts in rheumatoid arthritis in Italy ($m), 2007-2017
    • Table 21: Sales forecasts in rheumatoid arthritis in Spain ($m), 2007-2017
    • Table 22: Sales forecasts in rheumatoid arthritis in the UK ($m), 2007-2017
    • Table 23: Comparison of leading branded drug sales ($m) for rheumatoid arthritis in the seven major markets and the Rest of World (ROW), 2007
    • Table 24: Leading branded drug sales ($m) for rheumatoid arthritis, 2007-2017
    • Table 25: Key products in late-stage R&D pipeline for rheumatoid arthritis, 2008
    • Table 26: Mean scores for considerations in choosing biologic response modifier therapy for rheumatoid arthritis, 2008
    • Table 27: Summary of patient preferences regarding anti-TNF therapy, showing first choices only
    • Table 28: Factors influencing prescribing decision for anti-TNFs and cytokine biologics in rheumatoid arthritis in the seven major markets, 2008
    • Table 29: Formulary status in the US for leading brands in rheumatoid arthritis, 2008
    • Table 30: Datamonitor's standard unit definition and dosing assumptions for marketed and pipeline products in rheumatoid arthritis market, 2008
    • Table 31: Efficacy of the anti-TNFs: American College of Rheumatology 20, 50 and
    • Table 32: Safety of TNF inhibitors, 2008
    • Table 33: Enbrel - Drug profile, 2008
    • Table 34: Ongoing and recently completed clinical trials of Enbrel (etanercept) in juvenile idiopathic rheumatoid arthritis, 2008
    • Table 35: Impacting factors on the revenues of Enbrel, 2007-2017
    • Table 36: Remicade - Drug profile, 2008
    • Table 37: Ongoing post-marketing studies for Remicade in rheumatoid arthritis, 2008
    • Table 38: Impacting factors on the revenues of Remicade, 2007-2017
    • Table 39: Humira - Drug profile, 2008
    • Table 40: Impacting factors on the revenues of Humira, 2007-2017
    • Table 41: Simponi - Target product profile, 2008
    • Table 42: Clinical trial summary for subcutaneous formulation of Simponi (golimumab)
    • Table 43: Clinical trial summary for intravenous formulation of Simponi (golimumab), 2008
    • Table 44: Simponi (golimumab) efficacy summary: Clinical trial data from GO-FORWARD, GO-AFTER and GO-BEFORE, 2008
    • Table 45: Comparison of the route of administration and dosing frequency of the anti-TNFs in rheumatoid arthritis
    • Table 46: Impacting factors on the revenues of Simponi (golimumab), 2007-2017
    • Table 47: Cimzia- Target product profile, 2008
    • Table 48: Cimzia (certolizumab): Pivotal Phase III clinical trials
    • Table 49: Cimzia (certolizumab): Ongoing clinical trials, 2008
    • Table 50: Results of Cimzia's RAPID-1 and RAPID-2 clinical trials
    • Table 51: Impacting factors on the revenues of Cimzia, 2007-2017
    • Table 52: Actemra - Drug profile, 2008
    • Table 53: Actemra (tocilizumab): Pivotal Phase III trials
    • Table 54: Actemra (tocilizumab): summary of results from pivotal Phase III trials OPTION, TOWARD, RADIATE and AMBITION
    • Table 55: LITHE study results: Inhibition of radiographic progression at Week
    • Table 56: Actemra (tocilizumab): summary of results from SAMURAI and SATORI trials
    • Table 57: Impacting factors on the revenues of Actemra, 2007-2017
    • Table 58: Orencia - Drug profile, 2008
    • Table 59: Completed Phase III clinical trials for Orencia (abatacept)
    • Table 60: Ongoing clinical trials for Orencia (abatacept) in rheumatoid arthritis, 2008
    • Table 61: The efficacy of abatacept in methotrexate-nave patients with early erosive rheumatoid arthritis and poor prognostic factors, 2008
    • Table 62: Phase IIIb studies for subcutaneous formulation of Orencia (abatacept), 2008
    • Table 63: Impacting factors on the revenues of Orencia, 2007-2017
    • Table 64: Rituxan/MabThera - Drug profile, 2008
    • Table 65: Comparison of ACR efficacy scores in the TNF-failure patient population: Rituxan/MabThera versus Orencia
    • Table 66: Impacting factors on the revenues of Rituxan/MabThera, 2007-2017
    • Table 67: Ocrelizumab - Drug profile, 2008
    • Table 68: Ocrelizumab ACR efficacy data from Phase II ACTION trial, 2007
    • Table 69: Ocrelizumab Phase III clinical trial details, 2008
    • Table 70: Impacting factors on the revenues of ocrelizumab, 2007-2017
    • Table 71: Ofatumumab - Drug profile, 2008
    • Table 72: Comparison of ofatumumab versus rituximab, 2008
    • Table 73: Ofatumumab's ACR and EULAR efficacy scores in DMARD-failure patients, 2007
    • Table 74: Efficacy of ofatumumab in DMARD-failure patients: 48 Week follow-up, 2008
    • Table 75: Ofatumumab: Ongoing Phase III and Phase II clinical trials, 2008
    • Table 76: Impacting factors on the revenues of ofatumumab, 2007-2017
    • Table 77: JAK inhibitors in development for rheumatoid arthritis, 2008
    • Table 78: CP-690,550: Phase IIb efficacy data, 2008
    • Table 79: Leading companies in the seven major rheumatoid arthritis markets, 2007-17
    • Table 80: Assessment of Amgen's rheumatoid arthritis portfolio, 2008
    • Table 81: Assessment of Roche's rheumatoid arthritis portfolio, 2008
    • Table 82: Assessment of Bristol-Myers Squibb's rheumatoid arthritis portfolio, 2008
    • Table 83: Scenario A: Simponi's US events and market share assumptions from launch in 2009
    • Table 84: Scenario B: Simponi's events and market share assumptions from launch
    • Table 85: Centocor/Johnson & Johnson's anti-TNF franchise sales in rheumatoid arthritis in the US, 2007-17
    • Table 86: Datamonitor's pricing scenarios for Simponi in the US, 2008
    • Table 87: Datamonitor's launch dates for rheumatoid arthritis products in the 5EU and US, 2007-2017
    • Table 88: Arava's brand erosion from time of first generic entrant, Q2 2005 to Q2 2007
  • List of Figures
    • Figure 1: Rheumatoid arthritis sales ($m) by drug class in the seven major markets, 2004-07
    • Figure 2: Key events impacting the rheumatoid arthritis market, 2005-08
    • Figure 3: Sales performance of the US, five major EU and Japan rheumatoid arthritis markets, 2006-07
    • Figure 4: Rheumatoid arthritis-specific sales ($m) by country, 2004-2017
    • Figure 5: Rheumatoid arthritis sales in the seven major markets, split by country, 2007-17
    • Figure 6: Number of rheumatoid arthritis patients receiving anti-TNF and non-TNF biologics in the seven major markets, 2007-17
    • Figure 7: Rheumatoid arthritis sales ($m) by drug class in US, 2004-07
    • Figure 8: US rheumatoid arthritis-specific sales by class, 2004-17
    • Figure 9: Rheumatoid arthritis-specific sales split by class in Japan ($m), 2004-07
    • Figure 10: Rheumatoid arthritis-specific of Remicade (infliximab) and Enbrel (etanercept), 2004-07
    • Figure 11: Performance of the key rheumatoid arthritis therapies in Japan ($m), 2005-2006
    • Figure 12: Japan rheumatoid arthritis-specific sales by class, 2004-17
    • Figure 13: Price per standard unit ($/SU) for Remicade (infliximab) in Japan, Q1 2007-Q2 2008
    • Figure 14: Rheumatoid arthritis-specific sales split by class in the 5EU ($m), 2004-07
    • Figure 15: Five major EU rheumatoid arthritis-specific sales by class, 2004-17
    • Figure 16: Five major EU rheumatoid arthritis-specific sales by class, 2004-17
    • Figure 17: France rheumatoid arthritis-specific sales by class, 2004-17
    • Figure 18: Germany rheumatoid arthritis-specific sales by class, 2004-17
    • Figure 19: Italy rheumatoid arthritis-specific sales by class, 2004-17
    • Figure 20: Spain rheumatoid arthritis-specific sales by class, 2004-17
    • Figure 21: Rheumatoid arthritis-specific sales split by class in UK ($m), 2004-07
    • Figure 22: Rest of World versus seven major market sales split in the rheumatoid arthritis market ($m), 2007
    • Figure 23: Annual sales ($m) in the Rest of World rheumatoid arthritis markets, split by region, 2004-07
    • Figure 24: Sales value of the largest 10 individual rheumatoid arthritis markets in the Rest of World, 2004-07
    • Figure 25: Rheumatoid arthritis patient care path, 2008
    • Figure 26: Drivers of brand choice for rheumatoid arthritis, 2008
    • Figure 27: Percentage of responses to question about who should choose treatment for patients with rheumatoid arthritis
    • Figure 28: Assessment of formulary status of leading biologic DMARDS in the US, 2008
    • Figure 29: Rheumatoid arthritis sales ($m) for TNF inhibitors in the seven major markets, 2004-17
    • Figure 30: Type of promotional activity for Enbrel as a percentage of total promotional spend in the US and five major EU markets, Q3 2005-Q2 2008
    • Figure 31: Wyeth/Amgen's advertisement for Enbrel in juvenile idiopathic arthritis from the ACR Scientific Meeting, 2008
    • Figure 32: Enbrel (etanercept): SWOT analysis, 2008
    • Figure 33: Enbrel sales ($m) in rheumatoid arthritis by country in the seven major markets, 2007-2017
    • Figure 34: Type of promotional activity for Remicade as a percentage of promotional spend in the US and five major EU markets, Q3 2005-Q2 2008
    • Figure 35: Remicade (infliximab): SWOT analysis, 2008
    • Figure 36: Remicade sales ($m) in rheumatoid arthritis by country in the seven major markets, 2007-2017
    • Figure 37: Type of promotional activity for Humira as a percentage of total promotional spend in the US and five major EU markets, Q3 2005-Q2 2008
    • Figure 38: Humira (adalimumab): SWOT analysis, 2008
    • Figure 39: Humira (adalimumab) sales ($m) by country in the seven major markets, 2007-17
    • Figure 40: Simponi (golimumab): SWOT analysis, 2008
    • Figure 41: Simponi (golimumab) sales ($m) by country in the seven major markets, 2007-17
    • Figure 42: Type of promotional activity for Cimzia as a percentage of total promotional spend in the US, Q2 2008
    • Figure 43: Cimzia (certolizumab): SWOT analysis, 2008
    • Figure 44: Cimzia sales ($m) in rheumatoid arthritis by country in the seven major markets, 2007-2017
    • Figure 45: Rheumatoid arthritis sales ($m) for other cytokine targets in the seven major markets, 2074-17
    • Figure 46: Actemra (tocilizumab): SWOT analysis, 2008
    • Figure 47: Actemra sales ($m) in rheumatoid arthritis by country in the seven major markets, 2007-2017
    • Figure 48: Promotional activity for Orencia by type as a percentage of promotional spend the US and EU (France, Germany, UK), Q3 2005-Q2 2008
    • Figure 49: Orencia (abatacept): SWOT analysis, 2008
    • Figure 50: Orencia sales ($m), split by formulation, in rheumatoid arthritis in the seven major markets, 2007-2017
    • Figure 51: Orencia sales ($m) in rheumatoid arthritis by country in the seven major markets, 2007-2017
    • Figure 52: Orencia, Rituxan/MabThera and Actemra sales ($m) in rheumatoid arthritis in the seven major markets, 2007-2017
    • Figure 53: Rituxan/MabThera (rituximab): SWOT analysis, 2008
    • Figure 54: Rituxan/MabThera sales ($m) in rheumatoid arthritis by country in the seven major markets, 2007-2017
    • Figure 55: Ocrelizumab: SWOT analysis, 2008
    • Figure 56: Ocrelizumab sales ($m) in rheumatoid arthritis by country in the seven major markets, 2007-2017
    • Figure 57: Rituxan/MabThera (rituximab) and ocrelizumab sales ($m) in rheumatoid arthritis in the seven major markets, 2007-2017
    • Figure 58: Ofatumumab: SWOT analysis, 2008
    • Figure 59: Ofatumumab sales ($m) in rheumatoid arthritis by country in the seven major markets, 2007-2017
    • Figure 60: Ofatumumab sales ($m), split by formulation, in rheumatoid arthritis in the seven major markets, 2007-2017
    • Figure 61: Overview of key players with marketed and pipeline drugs in rheumatoid arthritis market, 2008
    • Figure 62: Estimated number of patients treated with biologics split by line and type of therapy, 2006-17
    • Figure 63: Estimated rheumatoid arthritis sales ($m) forecast for biologic brands in the seven major markets, 2006-17
    • Figure 64: Estimated uptake of biologics in moderate and severe rheumatoid arthritis patients in the seven major markets, 2006-17
    • Figure 65: Datamonitor's estimated percentage of patients receiving biologics, by type of therapy, at each line of therapy in 2007 and 2017
    • Figure 66: Datamonitor's sensitivity analysis for biologic sales ($m) in rheumatoid arthritis in the seven major markets, 2017
    • Figure 67: Simponi's rheumatoid arthritis sales in the US assuming an immediate switch from Remicade to subcutaneous Simponi formulation, 2007-17
    • Figure 68: Simponi's rheumatoid arthritis sales in the US assuming a delayed switch from Remicade to intravenous Simponi formulation, 2007-17
    • Figure 69: Simponi's rheumatoid arthritis sales under each pricing scenario in the US, 2007-17

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